ADD - Attention Deficit Disorder

Overview, Causes, & Risk Factors

Attention deficit disorder, which is also called ADD, is a disorder in which a person shows a certain pattern of behavior over time. This pattern includes inattention and impulsivity. Attention deficit hyperactivity disorder, or ADHD, adds hyperactivity to the other behaviors.

What is going on in the body?

In people who have ADD, the brain areas that control attention use less glucose than the brains of other people use. This indicates that the areas are less active. The lower activity level seems to cause inattention. No one knows for sure why these brain areas are less active.

What are the causes and risks of the condition?

No one knows the exact cause of ADD. Most experts believe that the following factors may play a role in causing ADD and ADHD:

  • environmental toxins, such as lead
  • genetics
  • smoking or alcohol use by the mother during pregnancy
  • use of illegal drugs, such as cocaine, by the mother during pregnancy

    • ADD is thought to affect 5% to 10% of school-age children. Boys are 10 times more likely than girls to be affected by ADD.

    Symptoms & Signs

    What are the signs and symptoms of the condition?

    People who have ADD show signs of inattention, including the following:

  • being easily distracted by sights, sounds, and other stimuli
  • losing or forgetting tools and materials needed for a job
  • making careless mistakes because of poor attention to details

    • Someone who has ADHD may also show signs of impulsivity and hyperactivity, such as:

  • feeling restless much of the time
  • fidgeting or squirming
  • having trouble waiting in line
  • interrupting while another person is speaking
  • moving around when quiet behavior is expected

    • Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of ADD and ADHD begins with a medical history and physical exam. The healthcare provider will look for behaviors that are typical of ADD. In order to diagnose ADD, the provider must determine that the behaviors have the following characteristics:

  • are more frequent or severe than in other people of the same age group
  • create significant disability in at least two of the following areas: school, home, work, or social settings
  • have continued for at least 6 months
  • started early in life, before age 7

    • The healthcare provider may order some of the following tests to rule out other disorders:

  • allergy tests
  • blood and urine tests
  • cranial CT scan
  • cranial MRI

    • Prevention & Expectations

    What can be done to prevent the condition?

    Many times, ADD and ADHD cannot be prevented. However, these measures may be helpful:

  • avoiding pregnancy risk factors, such as drugs, alcohol, and smoking
  • obtaining good prenatal care beginning in the first trimester of pregnancy
  • taking steps to avoid lead poisoning in the environment

    • What are the long-term effects of the condition?

    Without effective treatment, ADD and ADHD can cause serious problems at school, home, work, and in social settings.

    What are the risks to others?

    ADD is not contagious and poses no risk to others. There may be a genetic component to the disorder.

    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment for ADHD usually involves medicine along with one or more other strategies. The most common medicine for ADHD is a stimulant called methylphenidate. This medicine is known as Ritalin, Concerta, or Metadate. Other medicines used to treat ADHD include the following:

  • amphetamines, such as Adderall, Dexedrine, or Dextrostat
  • antidepressants, such as desipramine or bupropion
  • other stimulants, such as pemoline, or Cylert
  • medicines normally used to treat high blood pressure, such as clonidine

    • Medicines are often used together with other treatment strategies, such as:

  • anxiety \ \ depression \ \eating disorders such as anorexia nervosa and bulimia \ \ alcohol and drug abuse problems\ ',CAPTION,'Cognitive Behavioral Therapy');" onmouseout="return nd();">cognitive behavioral therapy
  • emotional counseling
  • practical support for activities of daily living
  • psychotherapy
  • social skills training for the individual
  • stress management training
  • support groups

    • What are the side effects of the treatments?

    Side effects from medicine can include the following:

  • headache
  • involuntary muscle movements
  • loss of appetite
  • mood changes as medicine wears off
  • sleep disorders
  • weight management problems

    • A person who is receiving any form of therapy may show an initial increase in negative behavior. This may last until new behaviors become routine.

    What happens after treatment for the condition?

    Treatment and monitoring of ADD and ADHD are lifelong.

    How is the condition monitored?

    Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:Michael Johnson, MD
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:09/30/01
    Reviewer:Barbara Mallari, RN, BSN, PHN
    Date Reviewed:09/07/01

    Sources

    "Attention-Deficit and Disruptive Behavior Disorders", V Sharma et al, in Psychiatry, A. Tasman et al, eds., 1997, pp. 667-682.

    "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence", CW Popper and RJ Steingard, in Synopsis of Psychiatry, RE Hales and SC Yudofsky, eds., 1996, pp. 681-774.

    Diagnostic and Statistical Manual of Mental Disorders, Fourth Ed. American Psychiatric Association Press, 1994.